Large surface area temperature sensing

ABSTRACT

A temperature probe for monitoring temperatures of a surface of a tissue or organ within the body of a subject includes a section with a substantially two-dimensional arrangement and a plurality of temperature sensors positioned across an area defined by the substantially two-dimensional arrangement. Such an apparatus may be used in conjunction with procedures in which thermal techniques are used to diagnose a disease state or treat diseased tissue. Specifically, a temperature probe may be used to monitor temperatures across an area of a surface of a tissue or organ located close to the treated tissue to prevent subjection of the monitored tissue or organ to potentially damaging temperatures.

CROSS-REFERENCE TO RELATED APPLICATION

This application is a division of U.S. patent application Ser. No.12/406,771, filed on Jan. Mar. 18, 2009, titled LARGE SURFACE AREATEMPERATURE SENSING DEVICE (“the '771 Application”). The '771Application claims the benefit of the Mar. 18, 2008, filing date of U.S.Provisional Patent Application No. 61/037,624 titled LARGE SURFACE AREATEMPERATURE SENSING DEVICE (“the '624 Provisional Application”). Theentire disclosure of each of the foregoing patent applications is herebyincorporated herein.

TECHNICAL FIELD

The present invention relates generally to apparatuses for monitoringtemperatures of an internal surface of a hollow organ in the body of asubject and, more specifically, to temperature monitoring apparatusesthat are configured to monitor temperatures at different locationsspread over an area of an internal surface of a hollow organ. Thepresent invention also relates to methods in which temperatures acrossareas of an internal surface of a hollow organ are monitored, includingtechniques in which an adjacent tissue or organ is heated or cooled.

BACKGROUND OF RELATED ART

A variety of techniques have been developed in which tissues or organsin a patient's body are heated or cooled. Tissues may be heated by avariety of techniques, including high frequency ultrasound,radiofrequency treatments, laser treatments, use of infrared radiation,and by direct application of thermal energy. Cooling is often effectedcryogenically. Techniques that heat and cool tissues may be collectivelyreferred to as “thermal techniques.”

Thermal techniques are useful for diagnosing a variety of disease statesand for treating a variety of disease states. More specifically, thermaltechniques may be used to diagnose and/or treat cancerous tissues, todestroy diseased tissues, to congeal blood, and to perform a variety ofother diagnostic and surgical procedures. Examples of organs that may besubjected to thermal techniques include the heart, the lungs,gastrointestinal organs, the liver, the pancreas, urological organs,prostates, reproductive organs, and skin.

The degree of heating or cooling that is required to optimize theefficiency of some thermal techniques may adversely affect tissues ororgans that are adjacent to a treated tissue or organ. For example, agreat deal of heat is generated when left atrium ablation techniques areused to treat atrial fibrillation in human subjects. In addition toheating and treating the diseased tissue in the heart H, the esophagusE, which is adjacent to the left atrium LA of the heart H, as shown inFIG. 1, may also be heated. As FIG. 1 illustrates, a typical humanesophagus E typically has a narrow oval shape that resembles a pancake,with a large portion of the outer surface of the esophagus E locatednext to or in contact with the left atrium LA, although the size, shape,and/or position of the esophagus E may vary. In an average human adult,about 58 mm of the length and the majority of the front side of a 14 mmdiameter esophagus E is located in proximity to or contacts the leftatrium LA. As a consequence of this intimate arrangement between theesophagus E and the left atrium LA, the heat generated during leftatrium ablation may damage the esophagus E and may, in some cases,create an esophageal fistula. Unfortunately, the complications thatarise from esophageal fistula often do not present themselves untilweeks after the procedure and, in many cases, at too late a time totreat and/or cure the sometimes fatal damage that has been done.

In recognition of the potentially dire consequences of overheating theesophagus during left atrial ablation, some physicians have startedusing catheters with single temperature sensors to monitor thetemperature within the subject's esophagus. Typically, a catheter with asize of 9 French (about 3 mm diameter) to about 18 French (about 64 mmdiameter) is used in conjunction with a conventional temperature sensor(e.g., an esophageal stethoscope available from Smiths Medical of Hythe,Kent, United Kingdom). If the sensed temperature reaches a predeterminedlevel, the physician may discontinue the left atrium ablationmomentarily to allow the esophagus to cool. The effectiveness of thesetechniques is limited, however, as a single temperature sensor may onlymonitor heat at a single location within the relatively large area ofthe esophageal wall located adjacent to the left atrium.

In an apparent effort to reduce the likelihood of esophageal fistuladuring left atrium ablation procedures, a variety of different types ofinflatable devices have been developed. Some inflatable devices areconfigured to cool the esophagus during left atrium ablation. Otherinflatable devices are configured to ensure contact between one or moretemperature sensors and the interior surface of the front of theesophageal wall. Despite assertions to the contrary, since the esophagusE is confined between the left atrium LA of the relatively rigid heart Hand the even more rigid vertebral column VC (see FIG. 1), any change inthe shape of the esophagus E by inflating a device that has beenintroduced into the esophagus E merely pushes or distends the esophagusE closer to, or into more intimate contact with, the left atrium LA. Theobvious result of such movement or distension is an increase in thelikelihood that a left atrium ablation procedure will cause anesophageal fistula. In addition, use of an inflatable device willundesirably prevent a subject from swallowing during the typicallylengthy (two to four hour) procedure, which may unnecessarily requirethat the subject be placed under general anesthesia during theprocedure.

SUMMARY

The present invention includes various embodiments of temperature probesconfigured to be positioned against internal organ surfaces. Atemperature probe that incorporates teachings of the present inventionincludes an elongate member and a plurality of temperature sensorscarried at discrete locations along the length of the elongate member.When disposed within the interior of a hollow organ, a section of theelongate member is configured to have a substantially two-dimensionalarrangement that arranges the temperature sensors in an area array. Thearrangement of the shaped section of the elongate member is referred toas a “substantially two-dimensional arrangement” to account for thethicknesses of the elongate element and the temperature sensors carriedthereby, as well as for any slight deviations of the elongate memberfrom a desired plane for the two-dimensional arrangement.

A substantially two-dimensional arrangement of a portion of atemperature probe of the present invention may, in some embodiments, bedefined during manufacture of the temperature probe or apparatus (e.g.,catheters, guide wires, shaping wires, etc.) that are to be usedtherewith. In other embodiments, a temperature probe or an apparatusthat is configured for use therewith may be configured to enable aphysician to define the substantially two-dimensional arrangement.

In some embodiments, the elongate member comprises a flexible elementwith a section that, in a relaxed state, is pre-shaped to a desired,substantially two-dimensional arrangement. Elongate members with suchcharacteristics may take on substantially linear, or one-dimensional,configurations when introduced into a linear catheter under stress but,upon removal of the pre-shaped section from the catheter, the pre-shapedsection returns to its relaxed state, in which it has a substantiallytwo-dimensional arrangement.

In other embodiments, the elongate member is an element that has asubstantially linear, or one dimensional, configuration, but includes asection that may be formed into a substantially two-dimensionalarrangement of desired configuration. A section of an elongate memberthat is ordinarily substantially linear may take on a substantiallytwo-dimensional arrangement when a wire that includes a section with thesubstantially two-dimensional arrangement is introduced into a lumen ofthe elongate member. Such a wire may itself be somewhat flexible orselectively flexible (e.g., depending upon its temperature, etc.), andits introduction into the interior of a hollow organ of a subject's bodymay be enabled by rigidity of a proximal and/or intermediate portion ofthe elongate member, a property (e.g., shape memory, etc.) of thematerial from which the wire is formed, or by any other suitable means.When the shaped portion of the wire is introduced into a correspondingflexible section of the elongate member, that section of the elongatemember may assume the substantially two-dimensional arrangement.

Other embodiments of temperature probes of the present invention includemechanisms for transforming substantially linear sections of elongatemembers to two-dimensional arrangements. In one such embodiment, anelongate element comprises a control wire, along with a multi-elementportion along a portion of the length of the control wire. Themulti-element portion includes at least two parallel arms that carrytemperature sensors. While the multi-element portion is contained withina catheter, it may have a substantially linear configuration. Once thecatheter has been introduced into the interior of a hollow organ, thecontrol wire may be moved distally to push the multi-element portion outof a distal end of the catheter. The control wire may then be drawn backtoward the distal end of the catheter, which engages an actuatorassociated with the at least two parallel arms and causes them to bowoutwardly, forcing the multi-element portion into a substantiallytwo-dimensional arrangement, such as a loop.

Other techniques for causing a section of a temperature probe to assumea substantially two-dimensional configuration (e.g., aspiration of airfrom a lumen extending through a section of the temperature probe,introduction of pressure into a lumen extending through a section of thetemperature probe, manipulation of a section of a temperature probefollowing its introduction into the body of a subject, etc.) are alsowithin the scope of the present invention.

The present invention includes techniques for introducing a temperatureprobe into the body of a subject with the temperature probe in asubstantially linear, or one-dimensional, configuration, then allowingor causing a section of an elongate member of the temperature probe toassume the substantially two-dimensional arrangement when that sectionof the temperature probe is at a desired location within the subject'sbody.

In addition to including various embodiments of temperature probes, thepresent invention also includes embodiments of methods, or procedures,in which the temperatures at various locations over an area of a bodytissue are monitored. When such a procedure is conducted, a first tissueor organ of a subject's body is subjected to a thermal technique whiletemperature is monitored over an area of an adjacent, second tissue ororgan of the subject's body. In some embodiments, the temperature of thesecond tissue or organ may be monitored without substantial deformationof the second tissue or organ, without substantial displacement of thesecond tissue or organ, and/or without preventing the second tissue ororgan from functioning. Additionally, if any portion of the monitoredarea approaches a potentially damaging (cold or hot) temperature,precautionary measures may be taken. Various embodiments of suchprecautionary measures include, but are not limited to, temporarytermination of the thermal technique, movement of the affected portionof the second tissue or organ away from the first tissue or organ,and/or changing the temperature of the affected portion of the secondtissue or organ.

In a specific embodiment, the method of the present invention may beeffected during left atrial ablation, which is a surgical procedure thatmay be used to treat atrial fibrillation. During a left atrial ablationprocedure, temperature may be monitored at a plurality of locationsspaced over an area of an interior surface of a front portion of asubject's esophageal wall that is located adjacent to the left atrium ofthe subject's heart. Such temperature monitoring may be effected withoutany substantial change in the shape of the esophagus, without anysubstantially displacement of the monitored portion of the esophagus,and without blocking the esophagus or otherwise preventing the subjectfrom swallowing. If any portion of the sensed area approaches apotentially damaging temperature, cautionary measures may be taken. Invarious embodiments, the left atrial ablation procedure may betemporarily terminated, the heated portion of the esophagus may be movedaway from the left atrium, and/or the heated portion of the esophagusmay be cooled.

Other embodiments of procedures in which thermal techniques are employedare also within the scope of the present invention, including, withoutlimitation, monitoring the temperature of the trachea during ablation ofthe pulmonary vein; monitoring the temperature of the ureters and/orcolon during thermal treatment of the prostate; monitoring thetemperature of and, optionally, flattening a portion of the duodenum ofthe small intestine during thermal treatment of the liver (e.g., totreat hepatic carcinoma, etc.); monitoring the temperature of the cysticduct, gall bladder, and/or stomach during thermal treatment of theliver; monitoring brain temperature through tissues lining the nasalcavities; monitoring the temperature of tissues in the nasal cavitiesduring thermal pharyngeal procedures; and monitoring tissues of oradjacent to the kidneys while breaking up kidney stones.

Other aspects, as well as various features and advantages, of thepresent invention will become apparent to those of ordinary skill in theart through consideration of the ensuing description, the accompanyingdrawings, and the appended claims.

BRIEF DESCRIPTION OF THE DRAWINGS

In the drawings:

FIG. 1 is a cross-sectional representation of a portion of a human bodyillustrating the relationship between the esophagus and the heart;

FIG. 2 depicts an embodiment of a temperature probe with an elongatemember that includes a section with a substantially two-dimensionalarrangement and temperature sensors arranged along the section of theelongate member in such a way that, when the section is in itssubstantially two-dimensional arrangement, the temperature sensors arearranged in an area array;

FIGS. 2A and 2B illustrate different embodiments of the elongate membersof a temperature probe of the present invention;

FIG. 3 illustrates the embodiment of temperature probe shown in FIG. 2,in a substantially linear, or one-dimensional, configuration whendisposed within a lumen of a catheter having a substantially linear, orone-dimensional, configuration;

FIG. 4 depicts relaxation of a segment of the embodiment of temperatureprobe shown in FIG. 2 to its substantially two-dimensional arrangementupon exiting a distal end of the catheter of FIG. 3;

FIG. 5 shows an embodiment of a temperature probe with an elongatemember that includes a flexible section that, in its relaxed state, maybe substantially linear, or one-dimensional, and that includes aflexible section that carries a plurality of temperature sensors;

FIG. 6 illustrates an embodiment of a shaped wire with a section that,in its relaxed state, has a substantially two-dimensional arrangement;

FIG. 7 depicts introduction of the embodiment of temperature probe shownin FIG. 5 into an interior of a hollow organ of a subject;

FIG. 8 depicts introduction of the shaped wire of FIG. 6 into thetemperature probe of FIG. 5, with the section that has the substantiallytwo-dimensional arrangement deformed to a substantially linear, orone-dimensional, configuration;

FIG. 9 shows the flexible section of the temperature probe of FIGS. 5and 6 in a substantially two-dimensional arrangement when the shapedportion of the wire of FIG. 6 assumes its substantially two-dimensionalarrangement within the flexible section;

FIGS. 10 through 17 depict various embodiments of two-dimensionalconfigurations in which a section of a temperature probe of the presentinvention may be arranged;

FIGS. 18 through 20 illustrate an embodiment of temperature probeconfigured to be mechanically arranged in a substantiallytwo-dimensional arrangement upon being positioned at or near a desiredlocation;

FIGS. 21 and 22 depict embodiments of temperature probes that includesimilar elements to the embodiment shown by FIGS. 18 through 20; and

FIG. 23 schematically depicts use of an embodiment of a temperatureprobe of the present invention in conjunction with a procedure in whicha thermal technique is employed.

DETAILED DESCRIPTION

As shown in FIG. 2, a temperature probe 10 according to an embodiment ofthe present invention includes an elongate member 20 with a proximalportion 22, an intermediate portion 24, and a distal portion 26. Inaddition, temperature probe 10 includes a plurality of temperaturesensors 30 located along one or both of intermediate portion 24 anddistal portion 26. More specifically, temperature sensors 30 arepositioned along a section 28 of elongate member 20 that is configuredto have a substantially two-dimensional arrangement 40 when placedadjacent to or against an area of a surface of a tissue or organ in thebody of a subject. Section 28 may also carry other elements, such asradioopaque markers, echogenic markers, other sensors, and the like. Theshape of the substantially two-dimensional arrangement 40 distributesthree or more temperature sensors 30 over an area (e.g., an area arrayin the depicted embodiment) that is relatively large when compared withthe miniscule area covered by elongate member 20 itself. Temperaturesensors 30 may be arranged across an area array in which at least twosensors 30 spaced laterally (x-axis X) apart from each other a firstdistance that exceeds a width of elongate member 20 and at least twosensors 30 spaced vertically (y-axis Y) apart from each other a seconddistance that is at least as great as the first distance.

Elongate member 20 may, in various embodiments, have a length of about20 cm to about 200 cm. The substantially two-dimensional arrangement 40may have a width that exceeds a diameter of elongate member 20 by atleast ten percent. In a specific embodiment, the substantiallytwo-dimensional arrangement 40 covers an area with a width of about 10mm to about 30 mm and a length of about 40 mm to about 80 mm, althoughsubstantially two-dimensional arrangements that cover narrower areas,wider areas, shorter areas, and longer areas are also within the scopeof the present invention.

In some embodiments, such as that depicted by FIG. 2, section 28 ofelongate member 20 may be configured in the substantiallytwo-dimensional arrangement 40 while in a relaxed state. The materialfrom which elongate member 20 is formed may, in such embodiments, besomewhat flexible and elastic, at least under certain conditions (e.g.,when placed under a load, with or without other conditions), to enableelongation of section 28 from the substantially two-dimensionalarrangement 40 to a more linear, substantially one-dimensional,configuration. For example, section 28 may be elongated when placedunder a load within the lumen 52 of a catheter 50, as shown in FIG. 3.

A variety of materials are suitable for forming a pre-shaped butflexible elongate member 20 (or at least section 28 thereof), includingplastics and metal alloys. In embodiments where section 28 of elongatemember 20 is formed from a plastic, the plastic may comprise apolyester, a polyurethane, a latex, polyvinyl chloride, and thepolyether block amide marketed as PEBAX®. Metals and/or metal alloysthat may be used to form elongate member 20 include, but are not limitedto, shape memory alloys such as the nickel-titanium alloy referred to asNITINOL (for nickel titanium naval ordinance laboratory), steel,nickel-titanium, cobalt-chromium, and the cobalt-based alloy availableunder the trade name ELGILOY®. An elongate member 20 that is formed froma metal or metal alloy may, in some embodiments, be coated with a softerpolymer to prevent damage to the tissues and organs of the body of asubject into which temperature probe 10 is introduced. In someembodiments, the entire elongate member 20 may be formed from the samematerial, while other embodiments of elongate member 20 have hybridconstructions, such as a metal proximal portion 22 joined to a plasticor shape memory alloy distal portion 26.

As depicted by FIG. 2A, in some embodiments, including embodiments inwhich elongate member 20 is formed from a plastic, elongate member 20may comprise a tubular member with one or more lumens 21 a, 21 b, 21 c(three are shown) extending therethrough. Lumen 21 a of such an elongatemember 20 may be configured to accommodate wires (e.g., thermallyconductive elements or electrically conductive wires 32 that lead totemperature sensors 30, to other sensors, etc.) or other elements oftemperature probe 10. Lumen 21 b may be configured to transport fluidsinto (e.g., fluids that provide a heat sink, cooled fluids to decrease atemperature of the sensed tissue, heated fluids to increase atemperature of the sensed tissue, etc.) or out of the subject's body, orto provide a pathway by which other medical devices may be introducedinto the subject's body. Lumen 21 c of elongate member 20 may beconfigured to receive a guide wire.

As an alternative to wires 32 that extend through an interior (e.g.,through a lumen 21 a) of elongate member 20, wires 32 may be carriedupon an exterior of elongate member 20 (including embodiments in whichelongate member 20 includes one or more lumens 21 a, 21 b, 21 c, as wellas embodiments in which elongate member 20 lacks lumens, or has a solidcross-section), as illustrated by FIG. 2B. Various embodiments ofexternally carried wires 32 include wires that are defined by etching ametal film formed on an external surface of elongate member 20, wiresthat are stamped or printed onto the external surface of elongate member20, and wires that are discrete from, but carried by (e.g., wrappedaround, etc.) the external surface of elongate member 20. Of course, inembodiments where elongate member 20 is formed from a metal or metalalloy, electrically insulative elements (e.g., a dielectric coating,etc.) (not shown) may electrically isolate wires 32 that are carried bythe exterior surface of elongate member 20 from the material of elongatemember 20.

As depicted by FIG. 2B, in some embodiments, elongate member 20 may havea solid cross section.

Each temperature sensor 30 of temperature probe 10 may comprise anysuitable type of temperature sensor known in the art. In variousembodiments, thermocouples or thermistors that have been swaged to metalor thermally conductive (e.g., platinum, platinum-iridium, gold, etc.)sensors may be used as temperature sensors 30. Each temperature sensor30 may comprise a single element configured to detect a singletemperature at a particular location. Alternatively, one or moretemperature sensors 30 of a temperature probe 10 of the presentinvention may include a plurality of ganged temperature sensingelements, each of which may sense and/or report a different temperatureto provide a more accurate temperature reading at a particular location.

Wires 32 that communicate with temperature sensors 30 (or withindividual temperature sensing elements of a sensor 30) extendproximally along elongate member 20 to a suitable connector 34associated with proximal portion 22 of elongate member 20. In someembodiments, connector 34 may comprise a known 400 series connector or aknown series 700 connector, such as, or similar to, those manufacturedby Datex Ohmeda, GE Medical, Nihon Kohden, or Vital Signs, Inc.

Connector 34 enables connection of wires 32 and, thus, thermal sensors30 to a suitable temperature monitor (not shown) that, in turn,communicates with a processing element (not shown) associated with atemperature display system 36. In the depicted embodiment, displaysystem 36 includes a display element 37 that shows the temperatures 38a, 38 b, etc., monitored at various locations that correspond to thelocations of temperature sensors 30 in the substantially two-dimensionalarrangement 40 of section 28 of elongate member 20. Temperatures 38 a,38 b, etc., may be visually arranged in a manner that corresponds to thephysical arrangement of temperature sensors 30 across the substantiallytwo dimensional configuration 40. Additionally, display system 36 mayclearly identify the warmest and coolest sensed temperatures 38 a, 38 b,etc. (e.g., by color, such as red and blue, respectively; by fast andslow flashing, respectively; etc.). Display system 36 may also present arate 39 at which a sensed temperature is changing. The rate oftemperature change may be displayed numerically or, as depicted,graphically.

With reference to FIG. 3, an embodiment of a method for introducing atemperature probe 10 into a body of a subject is depicted. Specifically,temperature probe 10 is introduced into a lumen 52 of a substantiallylinear, or one-dimensional, catheter 50. Catheter 50 is sufficientlyrigid to cause section 28 of elongate element 20 of temperature probe 10to flex and, thus, to straighten while catheter 50 maintains itssubstantial linearity. In some embodiments, catheter 50 may also besufficiently flexible to move through curved cavities or vessels. Withthe non-linear, substantially two-dimensional arrangement 40 (FIG. 2) ofelongate element 20 of temperature probe 10 confined within lumen 52 ofcatheter 50 in a substantially linear configuration, temperature probe10 may be easily introduced into a hollow area H within the body of asubject.

Once distal portion 26 of elongate element 20 of temperature probe 10has been positioned within hollow area H, distal portion 26 and section28 may be pushed out of a distal end 54 of lumen 52 and into hollow areaH, where section 28 may assume its relaxed, substantiallytwo-dimensional arrangement 40, as shown by FIG. 4.

As an alternative to the use of a catheter to straighten temperatureprobe 10 and introduce a distal portion 26 of the same into hollow areaH, a proximal end of a guide wire whose distal end has already beenintroduced into hollow area H may be introduced into a lumen 21 c (FIG.2A) of elongate member 30. The rigidity of the guide wire may besufficient to straighten section 28 of elongate member 30, facilitatingits introduction into hollow area H. Once section 28 has been introducedto a desired location, the guide wire may be removed from lumen 21 c,allowing section 28 to assume the substantially two-dimensionalarrangement 40.

Another embodiment of temperature probe 10′ of the present invention isdepicted by FIGS. 5 through 9. As depicted by FIG. 5, temperature probe10′ comprises a substantially one-dimensional elongate member 20′ withthe same features as elongate member 20 (FIG. 2), with the primaryexception being that section 28′ of elongate member 20′ is not shaped tohave a substantially two-dimensional configuration 40 (FIG. 2). Instead,section 28′ of elongate member 20′ of temperature probe 10′ is flexible,and may be deformed to take on a substantially two-dimensionalconfiguration 40 (FIG. 2).

As depicted by FIGS. 6 and 7, a lumen 21′ that extends through thelength of elongate member 20′ is configured to receive a shaped wire 60.As shown in FIG. 6, prior to its introduction into lumen 21′, shapedwire 60 includes a section 62 that, in its relaxed state, has asubstantially two-dimensional arrangement 64. Shaped wire 60 is aflexible element that may be substantially straightened. In variousembodiments, shaped wire 60 may be formed from a somewhat rigid, yetflexible plastic or a metal or metal alloy, such as a shape memory alloythat is flexible at room temperature, but that becomes rigid when heated(e.g., to a subject's body temperature, etc.).

FIG. 7 illustrates the introduction of distal and intermediate portions26′ and 24′ of elongate member 20′ of temperature probe 10 into a hollowarea H of the body of a subject. As elongate member 20′ is introducedinto hollow area H, so are temperature sensors 30 that are carried bysection 28′. Due to its substantially linear, or one-dimensionalconfiguration, known techniques may be used to introduce elongate member20′ into hollow area H.

Thereafter, shaped wire 60 may be introduced into lumen 21′ of elongatemember 20′ of temperature probe 10′, as illustrated by FIG. 8. As shapedwire 60 is introduced into lumen 21′, section 62 of shaped wire 60 maybe deformed (e.g., by the rigidity of a proximal portion 22′ and/orintermediate portion 24′ of elongate element 21′ (FIG. 5), bytemperature-dependent flexibility, etc.) to render section 62substantially linear, or to have a one-dimensional configuration. Suchdeformation of section 62 enables shaped wire 60 to be easily introducedinto a temperature probe 10′ that has been inserted into hollow area H.

When section 62 (FIG. 6) of shaped wire 60 has been introduced intosection 28′ of elongate member 20′ of temperature probe 10′, section 62may assume the substantially two-dimensional arrangement 64 (e.g., dueto flexibility of section 28′, upon being heated to or beyond atransition temperature, etc.), as depicted by FIG. 9. As section 62 ofshaped wire 60 assumes the substantially two-dimensional arrangement 64,the flexibility of section 28′ also allows it to be drawn into acorresponding, substantially two-dimensional arrangement 40′. Withsection 28′ of elongate member 20′ in the substantially two-dimensionalarrangement 40′, temperature sensors 30 (FIG. 5) that are carried bysection 28′ are spread across an area defined by the substantiallytwo-dimensional arrangement 40.

Referring now to FIGS. 10 through 16, various embodiments ofsubstantially two-dimensional arrangements 40 are depicted along withpossible arrangements of temperature sensors 30. Specifically, FIGS. 10through 12 show different embodiments of serpentine, or S, arrangements,while FIGS. 13 and 14 depict examples of spiral, or pigtail,arrangements, and FIGS. 15 and 16 illustrate different loopedarrangements. Of course, substantially two-dimensional arrangements 40of other shapes and configurations are also within the scope of thepresent invention.

FIG. 17 illustrates a forked embodiment of temperature probe 10″ with anenlarged distal portion 22″ that includes two or more substantiallyparallel arms 22 a″, 22 b″, etc. (the depicted embodiment includes adistal portion 22″ with three arms 22 a″, 22 b″, and 22 c″). Asillustrated, each arm 22 a″, 22 b″, and 22 c″ carries at least onetemperature sensor 30. In some embodiments, one or more arms 22 a″, 22b″, 22 c″, etc., may carry more than one temperature sensor 30.

FIGS. 18 through 20 illustrate another embodiment of temperature probe100, which is configured to be mechanically arranged in a substantiallytwo-dimensional arrangement upon being positioned at or near a desiredlocation.

As shown in FIG. 18, temperature probe 100 includes an introductorycatheter 150, an elongate member 120 at least partially carried byintroductory catheter 150, and a plurality of temperature sensors 30carried by a distal portion 126 of elongate member 120.

Elongate member 120 includes a proximally located pull wire 121. A userengagement element 110 is associated with a proximal end 122 of pullwire 121 to facilitate movement of elongate member 120 through a lumen152 of introductory catheter 150. Pull wire 121 may extend alongsubstantially the entire length of elongate member 120. In the depictedembodiment, an intermediate portion 124 of pull wire 121 extends througha slip ring 125, to which proximal ends 128 of two or more loop wires127 are secured. Each loop wire 127 carries at least one temperaturesensor 30 and, as depicted, at least one loop wire 127 may carry aplurality of temperature sensors 30. Distal ends 129 of loop wires 127are secured to pull wire 121 at or near its distal end 126. In someembodiments, distal ends 129 of loop wires 127 may be fixedly secured topull wire 121.

Distal end 126 of pull wire 121 may be configured or covered with anelement that prevents trauma to the tissues of a subject as pull wire121 is advanced distally and distal end 126 exits introductory catheter150.

In the arrangement shown by FIG. 18, loop wires 127 are contained withinlumen 152 of introductory catheter 150. This arrangement facilitates theintroduction of a distal portion of temperature probe 100 into a hollowarea of a subject's body. Once the distal portion of temperature probe100 has been placed at a desired location, elongate member 120 may bepushed distally through lumen 152 until proximal ends 128 of loop wires127 and slip ring 125 have exited a distal end 154 of lumen 152 ofintroductory catheter 150, as depicted by FIG. 19.

Thereafter, as shown in FIG. 20, pull wire 121 may be proximallywithdrawn. As pull wire 121 is proximally withdrawn, slip ring 125,proximal ends 128 of loop wires 127, and/or an engagement element (notshown) associated with slip ring 125 or with proximal ends 128 engagedistal end 154 of introductory catheter 150. As pull wire 121 is furtherwithdrawn and proximal ends 128 are held into place relative to distalend 154, loop wires 127 bow outwardly, providing a distal portion oftemperature probe 100 with a substantially two-dimensional arrangement140. While the distal portion of temperature probe 100 is in thesubstantially two-dimensional arrangement 140, temperature sensors 30that are carried by loop wires 127 are spread across an area defined bythe substantially two-dimensional arrangement 140. The area over whichloop wires 127 spread depends, of course, upon the degree to which pullwire 121 is withdrawn.

With reference again to FIG. 18, user engagement element 110 and pullwire 121 may associated with each other in such a way as to impart auser with control over an orientation of the substantiallytwo-dimensional arrangement 140. In some embodiments, user engagementelement 110 and pull wire 121 may be manipulated to enable deflection(e.g., of up to about 5°, etc.) of the substantially two-dimensionalarrangement 140 in any direction relative to an axis of elongate member120.

A position of pull wire 121 relative to introductory catheter 150 and,thus, the substantially two-dimensional arrangement 140 of the proximalportion of temperature probe 100, may be maintained by causing a lockingelement 159 associated with a proximal end 158 of introductory catheter150 to engage a proximal portion 122 of pull wire 121 (e.g., by screwinglocking element 159 down into proximal portion 122, etc.).

Instead of requiring that distal portion 126 of pull wire 121 bepartially withdrawn into lumen 152 of introductory catheter 150 toexpand loop wires 127, in other embodiments, a flexible element, such asa balloon 170 enclosed within a mesh basket 180 or a mesh basket 180alone, may be secured to loop wires 127, as shown in FIGS. 21 and 22,respectively. Balloon 170 may be inflated by known techniques. Meshbasket 180 may comprise a compressed element that, when removed fromlumen 152 of introductory catheter 150, automatically expands. Meshbasket 180 may have a substantially two-dimensional configuration (e.g.,having a narrow oval, or pancake, cross-sectional shape, etc.) so as tominimize or even prevent manipulation of the shape, displacement, and/orblockage of the hollow organ within which either of these elements areplaced. In embodiments including a balloon 170, mesh basket 180 mayconstrain the shape of the balloon 170 to the substantiallytwo-dimensional configuration. In some embodiments, balloon 170 or meshbasket 180 may carry temperature sensors 30.

With reference now to FIG. 23, an embodiment of a method, or procedure,is depicted in which an embodiment of temperature probe 10 of thepresent invention is used to monitor temperatures at a plurality oflocations across an area of a surface S of second tissue or an organ T₂in the body of a subject as a first tissue or organ T₁ of the subject'sbody is subjected to a thermal technique. A plurality of temperaturesensors 30 distributed across an area defined by a substantiallytwo-dimensional arrangement 40 of a section 28 of an elongate member 20is placed against surface S. Section 28 may be placed against surface Swithout substantially deforming surface S or the shape of second tissueor organ T₂ of which surface S is a part, without substantiallydisplacing any part of second tissue or organ T₂, and/or withoutpreventing second tissue or organ T₂ from functioning properly as thetemperature of surface S is monitored. In some embodiments, section 28may deform slightly to conform to a shape of surface S.

If any portion of the monitored area of surface S approaches apotentially damaging (cold or hot) temperature, precautionary measuresmay be taken. Various embodiments of such precautionary measuresinclude, but are not limited to, temporary termination of the thermaltechnique, changing the temperature of the affected portion of secondtissue or organ T₂, and/or movement of the affected portion of secondtissue or organ T₂ away from first tissue or organ T₁. Variousembodiments for moving the affected portion of second tissue or organ T₂include, but are not limited to, deformation of second tissue or organT₂ to a flattened (e.g., narrowed oval) shape (e.g., by modifying anarea occupied by the substantially two-dimensional arrangement 40 ofsection 28, etc.), manipulation of a position of temperature sensor 10within the body of the subject to move a portion of second tissue ororgan T₂, or any other suitable technique for moving tissue withtemperature sensor 10.

Although the foregoing description contains many specifics, these shouldnot be construed as limiting the scope of the present invention, butmerely as providing illustrations of some embodiments. Similarly, otherembodiments of the invention may be devised which lie within the scopeof the present invention. Features from different embodiments may beemployed in combination. The scope of the invention is, therefore,indicated and limited only by the appended claims and their legalequivalents, rather than by the foregoing description. All additions,deletions and modifications to the invention as disclosed herein whichfall within the meaning and scope of the claims are to be embracedthereby.

What is claimed is:
 1. A left atrial ablation method, comprising:introducing a temperature probe into an esophagus of an individual;placing a temperature-sensing portion of the temperature probe againstan interior surface of a portion of the esophagus located adjacent to aleft atrium of a heart of the individual, the act of placing thetemperature-sensing portion including positioning a plurality oftemperature sensors arranged in an area array against the interiorsurface of the portion of the esophagus; with the plurality oftemperature sensors positioned against the interior surface of theesophagus, ablating abnormal tissue of a wall of the left atrium of theheart of the individual from an interior of the left atrium; andmonitoring a temperature of the interior surface of the portion of theesophagus with the plurality of temperature sensors while ablating theabnormal tissue.
 2. The left atrial ablation method of claim 1, whereinplacing the temperature-sensing portion of the temperature probe occurswhile visualizing a location of the temperature-sensing portion of thetemperature probe.
 3. The left atrial ablation method of claim 2,wherein visualizing the location of the temperature-sensing portion ofthe temperature probe comprises fluoroscopy.
 4. The left atrial ablationmethod of claim 2, wherein visualizing the location of thetemperature-sensing portion of the temperature probe comprisesultrasound.
 5. The left atrial ablation method of claim 1, whereinplacing comprises placing a temperature-sensing portion of thetemperature probe that distributes the plurality of temperature sensorsover an area having a height of about 40 mm to about 80 mm and a widthof about 10 mm to about 30 mm against the interior surface.
 6. The leftatrial ablation method of claim 1, wherein placing thetemperature-sensing portion of the temperature probe against theinterior surface of the portion of the esophagus located adjacent to theleft atrium of the heart of the individual comprises placing thetemperature-sensing portion against a front surface of the esophagus. 7.The left atrial ablation method of claim 1, wherein: introducingcomprises introducing a temperature probe including atemperature-sensing portion with a serpentine configuration into theesophagus of the individual; and placing comprises placing at least aportion of the serpentine configuration against the portion of theesophagus to position a plurality of temperature sensors carried by theserpentine configuration against the interior surface of the esophagus.8. The left atrial ablation method of claim 1, wherein placing thetemperature-sensing portion of the temperature probe against theinterior surface of the portion of the esophagus located adjacent to theleft atrium of the heart of the individual occurs without anysubstantial change in a shape of the esophagus.
 9. The left atrialablation method of claim 1, wherein placing the temperature-sensingportion of the temperature probe against the interior surface of theportion of the esophagus located adjacent to the left atrium of theheart of the individual occurs without any substantial displacement ofthe portion of the esophagus.
 10. The left atrial ablation method ofclaim 1, wherein placing the temperature-sensing portion of thetemperature probe against the interior surface of the portion of theesophagus located adjacent to the left atrium of the heart of theindividual occurs without preventing the esophagus from functioningnormally.
 11. The left atrial ablation method of claim 10, whereinplacing the temperature-sensing portion of the temperature probe againstthe interior surface of the portion of the esophagus located adjacent tothe left atrium of the heart of the individual occurs without preventingthe individual from swallowing.
 12. The left atrial ablation method ofclaim 1, further comprising: taking precautionary measures if anyportion of the interior surface of the portion of the esophagus isheated to a potentially damaging temperature during the acts of ablatingand monitoring.
 13. The left atrial ablation method of claim 12, whereintaking precautionary measures includes at least temporarily terminatingthe act of ablating.
 14. The left atrial ablation method of claim 12,wherein taking precautionary measures includes cooling the portion ofthe interior surface of the portion of the esophagus that is heated to apotentially damaging temperature.
 15. The left atrial ablation method ofclaim 12, wherein taking precautionary measures includes moving theportion of the esophagus away from the left atrium.
 16. The left atrialablation method of claim 15, wherein moving the portion of the esophagusaway from the left atrium includes deforming a shape of the portion ofthe esophagus.
 17. The left atrial ablation method of claim 16, whereindeforming the shape of the portion of the esophagus comprises flattingthe portion of the esophagus.
 18. The left atrial ablation method ofclaim 15, wherein moving the portion of the esophagus away from the leftatrium includes repositioning the portion of the esophagus within thebody of the subject.
 19. The left atrial ablation method of claim 15,wherein moving the portion of the esophagus occurs by manipulating thetemperature probe.
 20. A thermal treatment method, comprising:introducing a temperature probe into a hollow organ of an individual;placing a temperature-sensing portion of the temperature probe againstan interior surface of a portion of the hollow organ located adjacent toanother organ of the individual that is to be thermally treated, the actof placing the temperature-sensing portion including positioning aplurality of temperature sensors arranged in an area array against theinterior surface of the portion of the hollow organ; with the pluralityof temperature sensors positioned against the interior surface of thehollow organ, thermally treating the other organ; and monitoring atemperature of the interior surface of the portion of the hollow organwith the plurality of temperature sensors while thermally treating theother organ.
 21. The thermal treatment method of claim 20, wherein:introducing comprises introducing the temperature probe into a tracheaof the individual; placing comprises placing the temperature-sensingportion of the temperature probe against an interior surface of aportion of the trachea located adjacent to a pulmonary vein of theindividual; and thermally treating comprises ablating the pulmonaryvein.
 22. The thermal treatment method of claim 20, wherein: introducingcomprises introducing the temperature probe into a ureter or a colon ofthe individual; placing comprises placing the temperature-sensingportion of the temperature probe against an interior surface of aportion of the ureter or the colon located adjacent to a prostate of theindividual; and thermally treating comprises thermally treating theprostate.
 23. The thermal treatment method of claim 20, wherein:introducing comprises introducing the temperature probe into a duodenumof the individual; placing comprises placing the temperature-sensingportion of the temperature probe against an interior surface of aportion of the duodenum located adjacent to a liver of the individual;and thermally treating comprises thermally treating the liver.
 24. Thethermal treatment method of claim 23, wherein placing includesflattening the portion of the duodenum.
 25. The thermal treatment methodof claim 20, wherein placing includes placing the temperature-sensingportion of the temperature probe against the interior surface of theportion of the hollow organ without: any substantial change in a shapeof the hollow organ; any substantial displacement of the portion of thehollow organ; and/or preventing the hollow organ from functioningnormally.
 26. The thermal treatment method of claim 20, furthercomprising: visualizing a location of the temperature-sensing portion ofthe temperature probe during or after placing the temperature-sensingportion of the temperature probe against the interior surface of theportion of the hollow organ.
 27. The thermal treatment method of claim26, wherein visualizing comprises fluoroscopically visualizing thelocation of the temperature-sensing portion of the temperature probe.28. The thermal treatment method of claim 26, wherein visualizingcomprises ultrasonically visualizing the location of thetemperature-sensing portion of the temperature probe.